The concept of collaborative practice stems from theories of quality management. The founders of quality management in industry emphasized the need for quality improvement as an integral part of the "fabric" of any "organization" (G. Sierchio, 2003, ¶6). The writings and teachings of quality management are being translated to apply to the healthcare industry. Studies have shown that the multidisciplinary team approach positively affects patient welfare and reduces healthcare costs (G. Sierchio, 2003, ¶7).
             Insulin pump therapy is a form of intensive diabetes therapy that aims to improve blood sugar control. It is referred to as "wearing your pancreas on your belt." Pump therapy is a personal choice and for it to be effective the client must be provided with the education and be willing to learn what is required to make it safe and effective. Starting pump therapy essentially means learning about diabetes all over again (Lawson, ¶7). Pump therapy is most successful when there is collaboration between the diabetes team that at the minimum consists of a physician, nurse, and dietitian knowledgeable in pump therapy.
             Mr. J. is a 57 year old diagnosed with Type 2 diabetes at the age of 34. Initial treatment was with Glyburide but after several years of therapy, oral medication was discontinued and insulin was instituted. In 2002, a certified pump nurse who was also a full time employee of MiniMed started him on a MiniMed insulin pump. His family physician referred him to our clinic in March 2004, as he was not familiar with pump therapy and felt he required a specialist consult.
             In obtaining Mr. J's history, it soon became apparent that he had not received the education needed for successful insulin pump therapy. The basic function of the pump is to provide basal insulin, which accounts for fifty percent of the total insulin need with meal boluses comprising the rest. Basal rates are pr...